scholarly journals Robotic Versus Conventional Nipple-Sparing Mastectomy With Immediate Breast Reconstruction

2021 ◽  
Vol 11 ◽  
Author(s):  
Gilles Houvenaeghel ◽  
Julien Barrou ◽  
Camille Jauffret ◽  
Sandrine Rua ◽  
Laura Sabiani ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Complication Rate ◽  
Immediate Breast Reconstruction ◽  
Predictive Score ◽  
Patient’S Satisfaction ◽  
Duration Of Surgery ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing ◽  
Complications Rate ◽  
Length Of Hospitalization

BackgroundSeveral studies reported the feasibility and safety of robotic-NSM (R-NSM). The aim of our prospective study was to compare R-NSM and conventional-NSM (C-NSM).MethodsWe analyzed patients who were operated on with and without robotic assistance (R-NSM or C-NSM) and who received immediate breast reconstruction (IBR) with implant or latissimus dorsi-flap (LDF). The main objective was complication rate and secondary aims were post-operative length of hospitalization (POLH), duration of surgery, and cost.ResultsWe analyzed 87 R-NSM and 142 C-NSM with implant-IBR in 50 and 135 patients, with LDF-IBR in 37 and 7 patients, respectively. Higher durations of surgery and costs were observed for R-NSM, without a difference in POLH and interval time to adjuvant therapy between R-NSM and C-NSM. In the multivariate analysis, R-NSM was not associated with a higher breast complication rate (OR=0.608) and significant factors were breast cup-size, LDF combined with implant-IBR, tobacco and inversed-T incision. Grade 2-3 breast complications rate were 13% for R-NSM and 17.3% for C-NSM, significantly higher for LDF combined with implant-IBR, areolar/radial incisions and BMI>=30. A predictive score was calculated (AUC=0.754). In logistic regression, patient’s satisfaction between C-NSM and R-NSM were not significantly different, with unfavorable results for BMI >=25 (OR=2.139), NSM for recurrence (OR=5.371) and primary breast cancer with radiotherapy (OR=4.533). A predictive score was calculated. In conclusion, our study confirms the comparable clinical outcome between C- NSM and R-NSM, in the price of longer surgery and higher cost for R-NSM. Predictive scores of breast complications and satisfaction were significantly associated with factors known in the pre-operative period.

scholarly journals Robot-assisted Nipple-sparing Mastectomy with Immediate Breast Reconstruction: An Initial Experience

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Hyung Seok Park ◽  
Jeea Lee ◽  
Dong Won Lee ◽  
Seung Yong Song ◽  
Dae Hyun Lew ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Learning Curve ◽  
Operation Time ◽  
Immediate Breast Reconstruction ◽  
Robot Assisted ◽  
Open Conversion ◽  
Areolar Complex ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Abstract Seeking smaller and indistinct incisions, physicians have attempted endoscopic breast surgery in breast cancer patients. Unfortunately, there are some limitations in the range of movement and visualization of the operation field. Potentially addressing these limitations, we investigated the outcomes of gas and gasless robot-assisted nipple-sparing mastectomy (RANSM) with immediate breast reconstruction (IBR). Ten patients underwent 12 RANSM with IBR between November 2016 and April 2018. Patients with tumors measuring >5 cm in diameter, tumor invasion of the skin or nipple-areolar complex, proven metastatic lymph nodes, or planned radiotherapy were excluded. Age, breast weight, diagnosis, tumor size, hormone receptor status, and operation time were retrospectively collected. Postoperative outcomes including postoperative complications and final margin status of resected were analyzed. The median total operation time and console time were 351 min (267–480 min) and 51 min (18–143 min), respectively. The learning curve presented as a cumulative sum graph showed that the console time decreased and then stabilized at the eighth case. There was no open conversion or major postoperative complication. One patient had self-resolved partial nipple ischemia, and two patients experienced partial skin ischemia. We deemed that RANSM with IBR is safe and feasible for early breast cancer, benign disease of the breast, and BRCA 1/2 mutation carriers. RANSM is an advanced surgical method with a short learning curve.

Robotic Nipple-Sparing Mastectomy and Immediate Breast Reconstruction With Robotic Latissimus Dorsi Flap Harvest: Technique and Results

2020 ◽  
pp. 155335062091791
Author(s):  
Gilles Houvenaeghel ◽  
Monique Cohen ◽  
Sandrine Rua Ribeiro ◽  
Julien Barrou ◽  
Mellie Heinemann ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Complication Rate ◽  
Surgical Procedure ◽  
Latissimus Dorsi ◽  
Immediate Breast Reconstruction ◽  
Latissimus Dorsi Flap ◽  
Axillary Lymph ◽  
Grade 3 ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Introduction. Only few cases of robotic latissimus dorsi flap reconstruction (RLDFR) have been reported in indication of reconstruction for breast cancer (BC). We report our experience of combined robotic nipple-sparing mastectomy (R-NSM) and RLDFR, and analyze technique, indications, and reproducibility. Methods. All patients with R-NSM and RLDFR from November 2016 to August 2, 2018, were analyzed, and technics have been described. Complication rate with Clavien-Dindo grading and postoperative hospitalization length (days) are reported. Results. Thirty-five R-NSM with RLDFR were performed in 22 cases for primitive BC and 13 for local recurrence. In 12 patients, another surgical procedure was performed during the same time (axillary lymph node dissection or contralateral breast surgery). R-NSM was realized through a short axillar incision, with inside-only installation for 12 patients (34.3%): 18 nonautologous and 17 autologous RLDFR associated with implant in 9 patients. In logistic regression, mastectomy weight >330 g was significantly associated with the use of implant (odds ratio [OR] = 17, P = .015), and significant factor of the time of anesthesia ≥380 minutes was 2 installations (OR = 10.4, P = .049). The median duration of hospitalization stay was 4 days. Complications rates were 51.4% (18/35; 9 grade-1, 2 grade-2, and 7 grade-3). In logistic regression, associated other surgical procedure was predictive of grade-3 complications (OR = 6.87, P = .053). Conclusion. We confirmed the reproducibility and safety of R-NSM and RLDFR with a decreased complication rate. NSM was performed in 42.8% of our patients after previous radiotherapy. We observed an increase of grade-3 complications when R-NSM and RLDFR was combined to another surgical procedure.

Robotic Nipple-sparing Mastectomy and Immediate Breast Reconstruction With Implant

2017 ◽  
Vol 266 (2) ◽  
pp. e28-e30 ◽  
Author(s):  
Antonio Toesca ◽  
Nickolas Peradze ◽  
Viviana Galimberti ◽  
Andrea Manconi ◽  
Mattia Intra ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Immediate Breast Reconstruction ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

scholarly journals Capsular Flap for Implant Coverage in Breast Reconstruction Following Nipple-Sparing Mastectomy in Women With Previous Breast Augmentation

2019 ◽  
Vol 5 ◽  
pp. 2513826X1982879
Author(s):  
Miguel Sabino Neto ◽  
Luiz Henrique Gebrim
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Breast Augmentation ◽  
Prophylactic Mastectomy ◽  
Breast Implants ◽  
Immediate Breast Reconstruction ◽  
Silicone Implants ◽  
Capsular Flap ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

An increased incidence of breast cancer has been observed in women, including in those with silicone breast implants. We describe here the use of a flap made of fibrous capsule to complete the coverage of breast implants in patients undergoing nipple-sparing mastectomy with immediate breast reconstruction, who previously had undergone breast augmentation with silicone implants. All patients underwent ipsilateral therapeutic mastectomy and contralateral prophylactic mastectomy for breast cancer risk reduction and breast symmetrization. The capsular flap was successfully used in 16 patients. No postoperative complications occurred. This is a simple and safe technique and an additional option for this procedure.

Sign in / Sign up

Export Citation Format

Share Document